School Name:
School Address:
City:
State:
Zip:
School Phone Number:
Grade Level(s):
Subject Area(s):
Summary of PPDP Goals:
(Please describe your PPDP and what you hope to achieve with your plan.)
Statement of Need:
(Describe in detail the resources that you need which will be purchased with mini grant funds.)
Documentation of Costs:
(Create an itemized list of items you would like to purchase with your mini-grant funds. Include approximate costs that you have located in catalogues, brochures, websites, etc., and provide hyperlinks to those costs within your application as you are able.)
Expected Time Frame:
(Indicate when you will need mini-grant funds, as well as when you anticipate making your purchases. Receipts should be turned in no later than 60 days after your grant award has been made, and your summary of the impact of those purchases no later than June 30, 2009.)
Assurance & Signatures
(Once approved by your mentor for appropriateness, you will print out your mini-grant proposal, sign it, date it, and submit a paper copy to the grant director to serve as a contract between you and Intermediate Unit One. In the assurance and signature area, include the statement:
I ___ agree to:
spend my mini grant funds as specified in my application above
to submit all original receipts to the grant director within 60 days of purchases
to provide IU1 with a written summary of the impact of those funds
to return any un-used mini-grant funds to IU1 no later than June 30, 2009
and to pay out of pocket for any items that I purchase, which are not fully disclosed on my mini-grant application
Participant Signature and date
Faculty Signature and date
Date:
Name:
Email Address:
School Name:
School Address:
City:
State:
Zip:
School Phone Number:
Grade Level(s):
Subject Area(s):
Summary of PPDP Goals:
(Please describe your PPDP and what you hope to achieve with your plan.)
Statement of Need:
(Describe in detail the resources that you need which will be purchased with mini grant funds.)
Documentation of Costs:
(Create an itemized list of items you would like to purchase with your mini-grant funds. Include approximate costs that you have located in catalogues, brochures, websites, etc., and provide hyperlinks to those costs within your application as you are able.)
Expected Time Frame:
(Indicate when you will need mini-grant funds, as well as when you anticipate making your purchases. Receipts should be turned in no later than 60 days after your grant award has been made, and your summary of the impact of those purchases no later than June 30, 2009.)
Assurance & Signatures
(Once approved by your mentor for appropriateness, you will print out your mini-grant proposal, sign it, date it, and submit a paper copy to the grant director to serve as a contract between you and Intermediate Unit One. In the assurance and signature area, include the statement:
I ___ agree to:
Participant Signature and date
Faculty Signature and date